REGULAR CONTENT
Final ID
614
Type
Educational Exhibit-Poster Only
Authors
F Valles1, W Ahmad2, M Akinyemi3, N Velasco4, T DiBartholomeo5, T Hughes6
Institutions
1Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT, 2Bridgeport Hospital, Bridgeport, CT, 3N/A, Hershey, PA, 4N/A, Greenwich, CT, 5N/A, Weston, CT, 6N/A, Trumbull, CT
Purpose
To understand the role of image guided lung nodule wire localization prior to video assisted thoracoscopic surgery (VATS) for wedge resection including the indications, techniques, imaging findings, and complications of the procedures.To review our institution's experience using three different preoperative lung nodule localization wires (microcoil, Q-wire, Homer) and their respective outcomes.
Materials & Methods
Localization of small nodules offers a challenge to surgeons. CT-guided percutaneous wire placement involves deployment of a localizing device through a needle with one end of the device at the nodule and the other end located outside the pleural surface. The pleural end is identified on the collapsed lung during surgery localizing the nodule to be selectively excised. Our institution utilizes a microcoil wire approach, a Q-wire approach, and Homer wire approach. We aim to compare and contrast the different techniques in this review.
Results
Retrospective review at our institution (2013-2016) demonstrated 13 patients (age 67.9 +/- 11.3 years) who underwent CT-guided lung nodule localization, 10 using microcoils, 2 using Q-wire and 1 using Homer wire. The average nodule size was microcoil 13 +/- 4 mm, Q-wire 14 +/- 1 mm, Homer 11mm. The average distance of localizing wire to center of lesion was microcoil 7 +/- 4 mm, Q-wire 1 +/- 1 mm, Homer 15 mm. Average time to perform procedure with microcoils 32.9 +/- 10.8 minutes, Q-wires 17.9 +/- 8.9 minutes, Homer 49.1 minutes. Pneumothorax developed in one microcoil case and the Homer case. Pleural surface was not reached by one of the microcoil wires. The diagnostic yield was 100% in our cohort.
Conclusions
Our institution performs pre-operative CT guided lung nodule localization utilizing various wires. Our data suggests the Q-wire approach offers the fastest method to localize these nodules and localized closest to the lesion. After reviewing this exhibit, the attendee will be able to understand the differences in the three devices used in our institution and learn from our experience with the devices.
Final ID
614
Type
Educational Exhibit-Poster Only
Authors
F Valles1, W Ahmad2, M Akinyemi3, N Velasco4, T DiBartholomeo5, T Hughes6
Institutions
1Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT, 2Bridgeport Hospital, Bridgeport, CT, 3N/A, Hershey, PA, 4N/A, Greenwich, CT, 5N/A, Weston, CT, 6N/A, Trumbull, CT
Purpose
To understand the role of image guided lung nodule wire localization prior to video assisted thoracoscopic surgery (VATS) for wedge resection including the indications, techniques, imaging findings, and complications of the procedures.To review our institution's experience using three different preoperative lung nodule localization wires (microcoil, Q-wire, Homer) and their respective outcomes.
Materials & Methods
Localization of small nodules offers a challenge to surgeons. CT-guided percutaneous wire placement involves deployment of a localizing device through a needle with one end of the device at the nodule and the other end located outside the pleural surface. The pleural end is identified on the collapsed lung during surgery localizing the nodule to be selectively excised. Our institution utilizes a microcoil wire approach, a Q-wire approach, and Homer wire approach. We aim to compare and contrast the different techniques in this review.
Results
Retrospective review at our institution (2013-2016) demonstrated 13 patients (age 67.9 +/- 11.3 years) who underwent CT-guided lung nodule localization, 10 using microcoils, 2 using Q-wire and 1 using Homer wire. The average nodule size was microcoil 13 +/- 4 mm, Q-wire 14 +/- 1 mm, Homer 11mm. The average distance of localizing wire to center of lesion was microcoil 7 +/- 4 mm, Q-wire 1 +/- 1 mm, Homer 15 mm. Average time to perform procedure with microcoils 32.9 +/- 10.8 minutes, Q-wires 17.9 +/- 8.9 minutes, Homer 49.1 minutes. Pneumothorax developed in one microcoil case and the Homer case. Pleural surface was not reached by one of the microcoil wires. The diagnostic yield was 100% in our cohort.
Conclusions
Our institution performs pre-operative CT guided lung nodule localization utilizing various wires. Our data suggests the Q-wire approach offers the fastest method to localize these nodules and localized closest to the lesion. After reviewing this exhibit, the attendee will be able to understand the differences in the three devices used in our institution and learn from our experience with the devices.